Watchful waiting prostate cancer - need advice

[Sylvana]

My Dad is 79 and was diagnosed about 5 years ago. He was told at the time he wouldn't need surgery to remove the prostate and he could continue with the watchful waiting option.

This treatment means a visit to his Urologist twice a year with the odd biopsy. His Urologist has recommended surgery on his last few visits due to the fact his PSA has now risen to 8.5. I don't know what his Gleeson score is.

My Dad is adamant he doesn't want surgery but his consultant is quite insistant - so much so that he doesn't even want to go back to him. We have suggested trying another Urologist but he doesn't want that either. He keeps saying he wants to stay with the watchful waiting option.

Myself and my Mum are afraid that if he leaves it the cancer will spread to the bones and causes a long and slow death. We know every case is different but we don't want to cause him grief and don't know what to do for the best.

Has anyone any advice ? Thank you.

At a PSA of 8.5 he needs to do something - but that doesn't need to be surgery. He could choose to take antiandrogens which will cut off the supply of hormones to the tumour (but give him a lot of side effects), brachytherapy (tiny radioactive sources put into the prostate, usually just one or two visits to the hospital and the side effects are pretty good after the first few weeks) or external beam radiotherapy.

At the moment his psa isn't too high, so he has lots of choice. But if it starts to rise a lot, those choices and his chance of being cured reduces, so he would be better thinking about it. He could go and talk to his gp about it as it shouldn't be his urologist pushing him into surgery as the only choice

My Dad (85 this year) had prostate cancer a couple of years ago - it was still contained, and as he was elderly he was given brachytherapy instead of surgery. Tiny seeds of radioactive material, as CMOT says - it did cause some unpleasant side effects for a few months (urgency, needing to get to the loo faster than usual - and a bit of diarrhoea for a couple of weeks, and tiredness) but he coped with it very well, and made a good recovery. His psa is still very low (normal) two years later.

I agree that the way to go is talk about other treatment options. The point of the watchful wait was to wait to start treatment not avoid it altogether! It's tough though because a lot is talked about the side effects and of course we would all like the horrible stuff just to go away and not have to be dealt with.

Thank you so much for all your helpful replies - its a relief to hear surgery isn't the only option. I'll get him to go to his GP to discuss these other treatments. His GP can then refer him to another Urologist. Thanks again :)